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Heart Health...continued from page 1 Medicare Supplement Enrollment Periods By Bill Proulx Senior Network Services Before we talk about supplements, we need to know a bit about original Medicare to see why sup- plements exist. Original Medicare is made up of Parts A & B. Part A is Hospital insurance, and Part B is Medical insur- ance. Parts A & B are pro- vided through the federal government for seniors and people with disabili- ties who have worked and paid into Social Security for ten years or more. Medicare Part A has a $1556 deductible (2022) and this deductible amount changes each year. A deductible means a patient has to pay this amount before Medicare will start to pay for the hospital services incurred by the patient. The de- ductible is not an annual deductible but a "benefit period" deductible. A benefit period ends when someone hasn't received inpatient hospital care (or skilled nursing care) for 60 days in a row. One can have multiple benefit peri- ods in a year meaning they could have to pay multiple deductibles in a year! Medicare Part B does have a monthly premium. In 2022 the premium is $170.10 (for someone earning $91k or less annually) and there is a $233 annual deductible. Part B only pays 80% of the expenses meaning the patient must pay the other 20%. As an example, a knee replacement surgery in the U.S. costs somewhere between $30,000 and $50,000. So 20% would be between $6000 and $10,000 that the patient would pay for Part B copay. Now that we have an idea of Medicare Parts A & B expenses, let's see how Medicare supple- ments play into Original Medicare. There are three different types of sup- plements sold by private insurance firms to en- hance Medicare benefits: Part D prescription plans, Part C Advantage Plans and Medigap supplement plans. Part D plans are supple- ments that cover prescrip- tion drugs approved by Medicare. Part D plans are annual plans, meaning they expire each Decem- ber and people should sign up for a plan between October 15 and December 7th of each year for the following year. Each year, two things can change that can affect the cost of someone's prescriptions. The price of a Part D plan can change, and a per- son's prescription list can change. Any change to one of these three things can drastically increase someone's prescription drug cost in a year. It is recommended that Medi- care beneficiaries conduct a Part D plan comparison each year. A ten-minute check can save a person hundreds to thousands of dollars. Medigap supplement plans are the only supple- ments that are not annual plans. When someone chooses to purchase a Medigap supplement plan, it is their plan for life if they choose. They are also labeled similarly to the different parts of Medicare by letters A, B, C , D and additional letters through N. Often, people will mix up Parts of Medicare with Medigap plans because of the lettered titles. As men- tioned earlier these plans do not expire each year. In California we do have the Birthday Rule which allows owners of Medigap supplement plans to shop around for plans of an equal number of benefits or fewer on their Birthday and for 60 days after their Birthday. For details about these Medigap Plans look for our HICAP Medicare Basics 101 or Medicare and U webinars. The Part C Advan- tage Plans are like the Part D plans timeline in that they also are annual plans. Each year enrollees will receive a "Plan Annual Notice of Change" notification letter about changes to their plan. These letters are normally sent out in September by one's in- surance plan. Individuals should read this letter to determine if the plan is still the best plan to meet their medical needs for the following year. For more details on Medicare Advantage plans, look for our HICAP Medicare Basics 101 or Medicare and U webinars. Like the Part D prescription drug plans, Medicare Advantage plans can be changed from October 15 to December 7 for the following January. To wrap it up, if you are on Medicare, and have a supplement plan, October 15 through December 7th you should be evaluating your Part D prescription plan or your Medicare Advantage plan which will start the following January. Your Medigap supplement plan can be a lifelong plan, but one can shop around at their Birthday and for 60 days after Birthday for a plan of equal benefits or less. Bigstock Photo dations are always chang- ing and sometimes seniors are told about "various fad diets, Whole 30, gluten-free, Paleo, Keto… too numerous to list. This can be very confusing and overwhelming. I recom- mend a simple version. A diet with colorful vegetables and fruits and whole foods that are not processed. I tell patients if it comes in a box, from a factory, or you have to microwave it… it's not healthy and has tons of sugars, salt, and preserva- tive. Keep it natural." The American Heart Association recently shared some diet and lifestyle recommenda- tions that Dr. Panameño finds helpful. "They even addressed whether some diets or food products are recommended or not. For starters, they stressed the importance that a healthy diet can improve cardio- vascular health and reduce the risk for heart disease by about 14-28%." Here are some highlights from the 2021 Dietary Guid- ance to Improve Cardio- vascular Health, using her own language: 1.Balance your energy consumption or in other words portion sizes, this is important for seniors. The older you get the less energy you need. 2.They recommended eat- ing plenty of vegetables and fruits, the more color- ful and more variety you add to your diet the better. They saw studies that doc- umented that vegetables and fruits of rich vibrant colors were linked to lower risk for CVD. They also had more fiber, which reduces blood sugar levels and provides a sensation of feeling fuller for longer. Frozen food has the same nutrient levels as fresh. 3.They emphasize plant- based proteins like nuts, beans, lentils, chickpeas, and split peas. These types of legumes can reduce the risk of heart disease. 4.They mention that meat alternatives are ultra-processed and that not enough studies are available to know their benefits and risk. So, they stuck to recommending unprocessed lean meats. 5.They recommend 2-3 servings of fish per week. Fried fish does not provide the same health benefits. 6.Low-fat dairy vs. full-fat dairy is controversial and still being studied. So, no recommendations were made for one or the other. 7.Processed red meat such as bacon, sausage, ground meat, or anything that has been smoked, salted, cured, or has added preservatives has a stronger association with cardiovascular disease. 8.They recommended reducing or avoiding added sugars. This includes natu- ral or alternative sweeten- ers, as there is no good data to support that alternative sweeteners have better outcomes on weight and metabolic effects. 9.Excess alcohol consump- tion carries a higher risk of cardiovascular disease and low alcohol consumption has been shown to have some benefits. But again, it has limited evidence. They do NOT support starting alcohol consumption for cardiovascular health prevention. So, for those who have read that a glass of wine a day protects the heart: this is NOT support- ed by the American Heart Association. 10.Get your minerals and vitamins from your diet. Not supplements. There is no support that shows supplements can prevent or reduce the risk of car- diovascular disease. 11.Coconut oil can raise LDL cholesterol, which is correlated to heart disease. And the studies have not shown that it carries many other health benefits. So, use sparingly. A couple more tips: "Dental health is an over- looked topic," says Dr. Panameño. "Many don't know that gum disease is associated with heart disease. The thought is that bacteria in the gum can cause inflammation leading to plaque build-up in the arteries, so people should floss and brush consistently and have reg- ular dental checkups." Also, women tend to go to the clinic for check- ups regularly "…partly because there are so many screenings in place for all stages of their life," says Dr. Panameño. "For men that can vary, as many screenings are for later in life, which I think affects whether men go routinely for checkups. I would like to take the time to encourage young and middle-aged men to go to the doctor yearly for a physical even if they feel fine. That way they can be healthier seniors. Many times, conditions such as diabetes, hypertension, and high cholesterol that place you at high risk for heart disease can be symptomless. People can live with high blood pressure and be complete- ly unaware they have it until it is too late, and they end up in the hospital with a heart attack or stroke. Please see your doctor early on even if you feel completely fine." After learning that Dr. Panameño is an El Salva- dor native who grew up in the East Bay, I asked her for any "heart healthy" foods/recipes from her culture that she'd like to share. "In reality, many of my cultural foods tend to be high in animal fat, fried in lard, and high in carbs. But I trained in a program with great teachers who loved to adapt and play with recipes and was encouraged and chal- lenged to make a healthier version. So, I try to play around using favorite rec- ipes substituting animal lard with vegetable oils and using the air fryer to make them healthy. Some come out okay, others are not so great," she ex- plains, laughing. "One of my favorite classics that is simple is Alguashte. It is a pumpkin seed seasoning that you can sprinkle on vegetables or fruits such as jicama, mango, orang- es, cucumbers, apples. It adds extra protein and fiber. The recipe is easy. You toast whole pumpkin seeds (with husk) until light brown. Let them cool. Put them in a grinder or blender with a little bit of salt. Blend until it becomes a fine powder, strain the big parts, and enjoy on fruit or vegeta- bles." Dr. Panameño joined the staff of Salud Para La Gente last August. "It is an honor to work at Salud Para La Gente serving families from the Pajaro Valley commu- nity," she says. "I chose to serve here because as a first-generation immi- grant physician I hope to empower my patients by providing comprehensive bi-cultural and bilingual preventive health care and to help them navigate the complexities of their chronic diseases and the medical system." Money Management in retirement By Donald Dimitruk RFC ® RMA A couple of decades ago, around 20% of Americans over the age of 65 had a mortgage. Today that figure is over 40%. Wanting to age in place, to stay in their home that is familiar and full of memories without the expense of mortgage, taxes and insurance for life is like a dream come true for some seniors and it shows in their positive energy that replaces their financial worry when their home equity takes over their home expense. True understanding of the today's Reverse Mortgage program is the key to the accepting the possibilities that a life of paying a mortgage can "Reverse" into a life of being paid by the mortgage! As of the end of 2021 homeowners ages 62 and older had accrued more that 8 trillion dollars in home equity. So why aren't more people getting Reverse Mortgages to take advantage of all that equity? To some extent, it stems from a lack of understanding about what having a Reverse Mort- gage can do and how it really works. It's not surprising that paying off existing mortgage debt is one of the main factors for many seniors in choosing to get a Reverse Mortgage. It's the equivalent to raising their disposable income by whatever the monthly mortgage payment was and most often that is enough to be a great financial stress reliever. But one of the primary reasons why people get denied for a Reverse Mort- gage is because they have too much housing debt already. The Reverse Mort- gage must be the primary mortgage on a property and no secondary loans are allowed. The FHA limits how much equity a borrower can take out of their property with a HECM government program to just 58% and the older you are, the closer you can get to that amount. Generally, for homeowners in their mid 70s, it's about 50%. One mortgage lender, Finance America Reverse, has rolled out a hybrid loan product that it believes could be the solution for those that carry too much debt into retirement. The loan is called "EQUITY AVAIL". It functions as a hybrid between a traditional forward mortgage and a Reverse Mortgage. With Equity Avail, home- owners refinance into a mortgage that does provide cash out from the start but also does have a month- ly payment, although a smaller one than their old loan and after the first 10 years it rolls into "no more payments for life" just like a standard Reverse Mortgage. If your present mortgage balance is too high to work with a standard HECM, this may be the solution for you! Professional financial planners and academics increasingly accept that Reverse Mortgages are a viable tool that can help millions of Americans enjoy a better retirement. Yet doubters remain, often because they truly don't understand today's Reverse Mortgage (HECM) and the many options that have been introduced in the past 5 years that are completely consumer positive and created to accommodate the longer life span and better health of today's senior population. Edu- cation is the key to help everyone understand the true power of a Reverse Mortgage to change lives. Donald Dimitruk is a Registered Financial Consultant ® and a Reg- istered Mortgage Advisor and is available for a FREE consultation about how a Reverse Mort- gage may benefit you at 831.464.6464

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